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Guilielmus H J M Ellenbroek, Gerardus P J van Hout, Leo Timmers, Pieter A Doevendans, Gerard Pasterkamp, Imo E Hoefer
Mortality after acute myocardial infarction remains substantial and is associated with significant morbidity, like heart failure. Novel therapeutics are therefore required to confine cardiac damage, promote survival and reduce the disease burden of heart failure. Large animal experiments are an essential part in the translational process from experimental to clinical therapies. To optimize clinical translation, robust and representative outcome measures are mandatory. The present manuscript aims to address this need by describing the assessment of three clinically relevant outcome modalities in a pig acute myocardial infarction (AMI) model: infarct size in relation to area at risk (IS/AAR) staining, 3-dimensional transesophageal echocardiography (TEE) and admittance-based pressure-volume (PV) loops...
October 14, 2016: Journal of Visualized Experiments: JoVE
Anukul Ghimire, Mads Andersen, Lindsay M Burrowes, James Christopher Bouwmeester, Andrew D Grant, Israel Belenkie, Nowell M Fine, Barry A Borlaug, John V Tyberg
Using the reservoir-wave approach (RWA) we previously characterized pulmonary vasculature mechanics in a normal canine model. We found reflected backward-travelling waves that decrease pressure and increase flow in the proximal pulmonary artery (PA). These waves decrease right ventricular (RV) afterload and facilitate RV ejection. With pathological alterations to the pulmonary vasculature, these waves may change and impact RV performance. Our objective in this study was to characterize PA wave reflection and the alterations in RV performance in cardiac patients, using the RWA...
October 20, 2016: Journal of Applied Physiology
Gisele de A Padilha, Lucas F B Horta, Lillian Moraes, Cassia L Braga, Milena V Oliveira, Cíntia L Santos, Isalira P Ramos, Marcelo M Morales, Vera Luiza Capelozzi, Regina C S Goldenberg, Marcelo Gama de Abreu, Paolo Pelosi, Pedro L Silva, Patricia R M Rocco
BACKGROUND: In patients with emphysema, invasive mechanical ventilation settings should be adjusted to minimize hyperinflation while reducing respiratory effort and providing adequate gas exchange. We evaluated the impact of pressure-controlled ventilation (PCV) and pressure support ventilation (PSV) on pulmonary and diaphragmatic damage, as well as cardiac function, in experimental emphysema. METHODS: Emphysema was induced by intratracheal instillation of porcine pancreatic elastase in Wistar rats, once weekly for 4 weeks...
December 2016: Intensive Care Medicine Experimental
Sarah Schalekamp-Timmermans, Jerome Cornette, Albert Hofman, Willem A Helbing, Vincent W V Jaddoe, Eric A P Steegers, Bero O Verburg
BACKGROUND: There are sex differences in the risk of development of cardiovascular disease (CVD). According to the developmental origins of health and disease paradigm (DOHaD), CVD originates in fetal life. This study examines fetal sex differences in cardiovascular development in utero. METHODS: In 1028 pregnant women, we assessed fetal circulation using pulsed wave Doppler examinations between 28 and 34 weeks gestation. To test associations between fetal sex and fetal circulation measurements, linear regression models were used adjusting for fetal size, gestational age, and fetal heart rate...
2016: Biology of Sex Differences
Junichiro Hashimoto
Arterial structure and function change progressively with advancing age. Owing to long-lasting repetitive stretch with intermittent cardiac contraction, elastic fibers in the tunica media of large arteries gradually degenerate and are replaced by collagenous fibers. Such medial degeneration causes elastic arteries to stiffen and dilate. However, the speed of the vascular aging varies considerably among individuals; a discrepancy often exists between the chronological age of an individual and the biological age of his or her arteries...
September 2016: Journal of Hypertension
Tomonori Sugiura, Hiroyuki Takase, Shunsuke Murai, Sumiyo Yamashiya, Nobuyuki Ohte, Yasuaki Dohi
OBJECTIVE: The heart is one of the target organs of hypertension. Cardiac muscle responds to an increase in afterload by developing hypertrophy. In the process of developing hypertension, the heart is exposed to a transiently, but frequent, increase in afterload. The present study was designed to test the hypothesis that left ventricular hypertrophy assessed by electrocardiography (ECG) predicts future development of hypertension. DESIGN AND METHOD: Normotensive subjects who visited our hospital for a physical check-up (n = 5770; age, 52...
September 2016: Journal of Hypertension
Krasimira Hristova, Rumen Marinov, Georgi Stamenov, Kristina Chacheva, Marina Michova, Sabina Persenska, Ani Racheva
OBJECTIVE: Normal pregnancy is associated with reversible changes in both systolic and diastolic mechanics, consistent with an increase in preload and decrease in afterload and systemic vascular resistance. The aim is to evaluate left ventricular (LV) twist and untwist mechanics in a population of pregnant women during differing stages of a healthy pregnancy. DESIGN AND METHOD: We included 22 pregnant patients, 10 with multiple pregnancy (mean age 36.5 ± 3 years) and 20 healthy non pregnant women (mean age 33 ± 4years)...
September 2016: Journal of Hypertension
Enrico Agabiti Rosei
Current Hypertension Guidelines emphasize the importance of assessing the presence of preclinical organ damage. In fact, an extensive evaluation of organ damage may increase the number of patients classified at high CV risk and therefore strongly influence the clinical management of patients. Hypertensive heart disease remains to date the form of organ damage for which there is the greatest amount of evidence of a strong independent prognostic significance. In the presence of a chronic pressure overload, a parallel addition of sarcomers takes place with an increase in myocyte width, which in turn increases left ventricular wall thickness; myocyte hypertrophy is also associated with apoptosis, collagen deposition and ventricular fibrosis with an impairment of coronary hemodynamics as well, thus profoundly influencing functional properties of the left (and right) ventricle...
September 2016: Journal of Hypertension
Junichiro Hashimoto
The central aorta constitutes the main trunk of the systemic arterial tree. It dilates passively with cardiac ejection during systole and then constricts with its recoil function during diastole, thereby regulating blood pressure and blood flow. The central pulsatile hemodynamics affects local hemodynamics within as well as downstream of the aorta (e.g., end organs).The aorta progressively stiffens and dilates with advancing age, and such age-dependent change is accelerated by hypertension. According to the law of Laplace, wall stress depends on the diameter and pressure of the blood vessel...
September 2016: Journal of Hypertension
Patricia Reant, Alexandre Metras, Dominique Detaille, Annabel Reynaud, Philippe Diolez, Beatrice Jaspard-Vinassa, Raymond Roudaut, Alexandre Ouattara, Laurent Barandon, Pierre Dos Santos, Stephane Lafitte
BACKGROUND: Left ventricular (LV) afterload could be associated with reduced myocardial contractility. The aim of this study was to evaluate the relative impact of increased afterload on LV myocardial deformation indices in chronic aortic constriction, with regard to hypertrophy, myocardial fibrosis, and mitochondrial function, and to differentiate acute versus chronic afterload effect. METHODS: Young pigs underwent aortic banding (n = 11) or sham (n = 7) operations...
October 14, 2016: Journal of the American Society of Echocardiography
Wonho Kim, Ramon Quesada, Melanie B Schernthaner, Raul E Herrera, Juan-Carlos Zevallos, Victor N Becerra, Juan M Acuña, Barry T Katzen
OBJECTIVE: We investigated whether successful revascularization of total occlusion of a large lower-extremity artery is associated with improvement of left ventricular (LV) diastolic function. BACKGROUND: Total occlusion of a large lower-extremity artery might affect the systemic vascular resistance and increase the afterload, because the left ventricle must work harder to eject blood into a smaller vascular bed. Chronic elevation of afterload is a cause of LV diastolic dysfunction...
October 15, 2016: Journal of Invasive Cardiology
Vicent Giménez-Alventosa, Javier Vijande, Facundo Ballester, Jose Perez-Calatayud
The goal of this study is to evaluate the ambient dose due to the transit of high dose rate (HDR) (60)Co sources along a transfer tube as compared to (192)Ir ones in a realistic clinical scenario. This goal is accomplished by evaluating air-kerma differences with Monte Carlo calculations using PENELOPE2011. Scatter from both the afterloader and the patient was not taken into account. Two sources, mHDR-v2 and Flexisource Co-60, (Elekta Brachytherapy, Veenendaal, the Netherlands) have been considered. These sources were simulated within a standard transfer tube located in an infinite air phantom...
October 14, 2016: Journal of Radiological Protection: Official Journal of the Society for Radiological Protection
Masaru Obokata, Yasufumi Nagata, Yuichiro Kado, Masahiko Kurabayashi, Yutaka Otsuji, Masaaki Takeuchi
BACKGROUND: Exercise-induced pulmonary hypertension (EIPH) may develop even at low workloads in heart failure (HF) patients. Ventricular-arterial stiffening plays an important role in the pathophysiology of HF with preserved ejection fraction (HFpEF). This study aimed to compare the response of ventricular-arterial coupling and PH during low-level exercise between HFpEF and HF with reduced EF (HFrEF). METHODS AND RESULTS: Echocardiography was performed at rest and during 10 W of bicycle exercise in HFpEF (n=37) and HFrEF (n=43)...
October 10, 2016: Journal of Cardiac Failure
M Iida, M Yamamoto, Y Ishiguro, M Yamazaki, N Ueda, H Honjo, K Kamiya
Left atrial (LA) phasic volumes consist of reservoir, conduit and booster pump volumes. Arterial stiffness is linked to lower systemic arterial compliance (SAC) contributing to cardiac afterload. Arterial stiffness may be a modulator of LA phasic volumes. Echocardiography was performed in 161 hypertensive patients and in 50 normotensive subjects in order to assess biplane LA volumes (maximum, before atrial contraction, minimum), early and late diastolic mitral annular velocity (e' and a'), and LV stroke volume...
October 13, 2016: Journal of Human Hypertension
Daisuke Murai, Satoshi Yamada, Taichi Hayashi, Kazunori Okada, Hisao Nishino, Masahiro Nakabachi, Shinobu Yokoyama, Ayumu Abe, Ayako Ichikawa, Kota Ono, Sanae Kaga, Hiroyuki Iwano, Taisei Mikami, Hiroyuki Tsutsui
Whether and how left ventricular (LV) strain and strain rate correlate with wall stress is not known. Furthermore, it is not determined whether strain or strain rate is less dependent on the afterload. In 41 healthy young adults, LV global peak strain and systolic peak strain rate in the longitudinal direction (LS and LSR, respectively) and circumferential direction (CS and CSR, respectively) were measured layer-specifically using speckle tracking echocardiography (STE) before and during a handgrip exercise...
October 12, 2016: Heart and Vessels
Jonathan P Mynard, Remi Kowalski, Michael M H Cheung, Joseph J Smolich
Wave reflection from the site of aortic coarctation produces a reflected backward compression wave (BCW) that raises left ventricular (LV) afterload. However, not all reflected wave power will propagate back to the LV. This study investigated the hypothesis that the BCW is partially transmitted into supra-aortic vessels as a forward wave and explored the consequences of this phenomenon for cerebral and LV haemodynamic load. In eight sheep, high fidelity pressure and flow were measured in the aortic trunk (AoT) and brachiocephalic trunk (BCT, the single supra-aortic vessel present in sheep) at baseline and during two levels of proximal descending aortic constriction...
October 11, 2016: Biomechanics and Modeling in Mechanobiology
Jeong Yoon Jang, Jeong-Sook Seo, Byung Joo Sun, Dae-Hee Kim, Jong-Min Song, Duk-Hyun Kang, Jae-Kwan Song
BACKGROUND: Left ventricle (LV) in patients with aortic stenosis (AS) faces a double hemodynamic load incorporating both valvular stenosis and reduced systemic arterial compliance (SAC). This study aimed to evaluate the impact of global LV afterload on LV hypertrophy (LVH) before and after aortic valve replacement (AVR). METHODS: The study cohort included 453 patients (247 males; mean age, 64 ± 11 years) who underwent AVR. Pre- and post-AVR echocardiographic examinations were retrospectively analyzed including an index of valvuloarterial impedance (ZVA) and LV mass index/LV end-diastolic volume index (LVMI/LVEDVI) as a parameter of LVH...
September 2016: Journal of Cardiovascular Ultrasound
Laura Mourino-Alvarez, Montserrat Baldan-Martin, Laura Gonzalez-Calero, Carlos Martinez-Laborde, Tamara Sastre-Oliva, Rafael Moreno-Luna, Luis F Lopez-Almodovar, Pedro L Sanchez, Francisco Fernandez-Aviles, Fernando Vivanco, Luis R Padial, Finn Akerstrom, Gloria Alvarez-Llamas, Fernando de la Cuesta, María G Barderas
BACKGROUND: The most common valve diseases are calcific aortic stenosis (AS) and aortic regurgitation (AR). The former is characterized by thickening of valve leaflets followed by progressive calcification, which produces progressive aortic valve (AV) narrowing, increased pressure afterload on the left ventricle (LV) and subsequent LV hypertrophy. On the other hand, AR is due to malcoaptation of the valve leaflets with resultant diastolic reflux of blood from aorta back to the LV producing volume and pressure overload and progressive LV dilatation...
September 26, 2016: International Journal of Cardiology
Federico Pappalardo, Christian Schulte, Marina Pieri, Benedikt Schrage, Rachele Contri, Gerold Soeffker, Teresa Greco, Rosalba Lembo, Kai Müllerleile, Antonio Colombo, Karsten Sydow, Michele De Bonis, Florian Wagner, Hermann Reichenspurner, Stefan Blankenberg, Alberto Zangrillo, Dirk Westermann
AIMS: Veno-arterial extracorporeal membrane oxygenation (VA-ECMO) support stabilizes patients with cardiogenic shock. Despite improved oxygenation and peripheral circulation, LV unloading may be impeded due to the increased afterload, resulting in a failing static left ventricle and in high mortality. METHODS AND RESULTS: We describe for the first time a large series of patients treated with the combination of VA-ECMO and Impella(®) compared with patients with VA-ECMO only...
October 6, 2016: European Journal of Heart Failure
Audun E Rimehaug, Eirik Skogvoll, Petter Aadahl, Oddveig Lyng, Dag O Nordhaug, Lasse Løvstakken, Idar Kirkeby-Garstad
Cardiac power, the product of aortic flow and blood pressure, appears to be a fundamental cardiovascular parameter. The simplified version named cardiac power output (CPO), calculated as the product of cardiac output (CO) in L/min and mean arterial pressure (MAP) in mmHg divided by 451, has shown great ability to predict outcome in a broad spectrum of cardiac disease. Beat-by-beat evaluation of cardiac power (PWR) therefore appears to be a possibly valuable addition when monitoring circulatory unstable patients, providing parameters of overall cardiovascular function...
October 2016: Physiological Reports
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